Differential diagnosis of pulmonary tuberculomas and malignant nodules using18F-FLT and 18F-FDG PET/CT imaging

CHEN Wen-xin; LIN Mei-fu; TIAN Jia-he; YANG Xiao-feng; YU Li-juan; WANG Xue-mei; XIN Jun; FENG Hui-ru; CHEN Ping; ZHAO Zhou-she; GUO Shen; CHEN Guo-bao

Journal of China Clinic Medical Imaging ›› 2012, Vol. 23 ›› Issue (12) : 837-840.

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Differential diagnosis of pulmonary tuberculomas and malignant nodules using18F-FLT and 18F-FDG PET/CT imaging

CHEN Wen-xin1, LIN Mei-fu1, TIAN Jia-he2, YANG Xiao-feng3, YU Li-juan4, WANG Xue-mei5,
XIN Jun6, FENG Hui-ru7, CHEN Ping8, ZHAO Zhou-she9, GUO Shen1, CHEN Guo-bao1

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Abstract

Objective: To investigate the diagnostic efficacies of 18F-FLT and 18F-FDG PET/CT in pulmonary nodules, focusing on diagnosis and differential diagnosis of pulmonary tuberculomas and malignant nodules. Materials and Methods: 163 patients with solitary pulmonary nodules undergoing dual-tracer imaging were certified by histological findings. The patients were collected from a multicenter clinical trial and were divided into the group of pulmonary tuberculoma(n=29), group of other benign nodule(n=48) and group of malignant nodule(n=88). The images were read in a standardized, blind, collective reading. The standardized uptake value(SUV) of 18F-FDG and 18F-FLT were compared and analyzed. Results: The SUVs of FDG and FLT in groups of malignant nodule, tuberculoma and other benign nodule were in a decreasing order. Both SUVFDG and SUVFLT showed significant difference in the group of malignant nodule and tuberculoma(P<0.001). ROC curve showed that a SUV cutoff of 5.9 on FDG PET/CT and 2.4 on FLT PET/CT provided the best separation of tuberculomas and malignancies. FLT PET/CT had higher diagnostic efficacy than FDG PET/CT(P<0.001). The ratio between SUVs of 18F-FLT and 18F-FDG improved the diagnostic efficacy in comparison with single tracer imaging. Conclusions: Dual-tracer imaging using 18F-FDG/18F-FLT PET/CT provides a better diagnostic efficacy in these clinically challenging patients with pulmonary lesions. A SUV cutoff of 5.9 on FDG PET/CT and 2.4 on FLT PET/CT provide the best separation of tuberculomas and malignancies. The ratio between SUVs of 18F-FLT and 18F-FDG provides great potential benefits in separating tuberculomas and malignancies.

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Tuberculosis / pulmonary / Lung neoplasms / Fluorodeoxyglucose F18 / Positron-emission tomography

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CHEN Wen-xin;LIN Mei-fu;TIAN Jia-he;YANG Xiao-feng;YU Li-juan;WANG Xue-mei;XIN Jun;FENG Hui-ru;CHEN Ping;ZHAO Zhou-she;GUO Shen;CHEN Guo-bao. Differential diagnosis of pulmonary tuberculomas and malignant nodules using18F-FLT and 18F-FDG PET/CT imaging[J]. Journal of China Clinic Medical Imaging. 2012, 23(12): 837-840